Thursday, February 25, 2010

And the bureaucrats responsible skate, with full pockets and no move for them to face any charges. See here

Patients were routinely neglected or left “sobbing and humiliated” by staff at an NHS trust where at least 400 deaths have been linked to appalling care. An independent inquiry found that managers at Mid Staffordshire NHS Foundation Trust stopped providing safe care because they were preoccupied with government targets and cutting costs. The inquiry report, published yesterday by Robert Francis, QC, included proposals for tough new regulations that could lead to managers at failing NHS trusts being struck off.

Staff shortages at Stafford Hospital meant that patients went unwashed for weeks, were left without food or drink and were even unable to get to the lavatory. Some lay in soiled sheets that relatives had to take home to wash, others developed infections or had falls, occasionally fatal. Many staff did their best but the attitude of some nurses “left a lot to be desired”.

The report, which follows reviews by the Care Quality Commission and the Department of Health, said that “unimaginable” suffering had been caused. Regulators said last year that between 400 and 1,200 more patients than expected may have died at the hospital from 2005 to 2008.

Andy Burnham, the Health Secretary, said there could be “no excuses” for the failures and added that the board that presided over the scandal had been replaced. An undisclosed number of doctors and at least one nurse are being investigated by the General Medical Council and Nursing and Midwifery Council.

Mr Burnham said it was a “longstanding anomaly” that the NHS did not have a robust way of regulating managers or banning them from working, as it does with doctors or nurses. “We must end the situation where a senior NHS manager who has failed in one job can simply move to another elsewhere,” he added. “This is not acceptable to the public and not conducive to promoting accountability and high professional standards.” A system of professional accreditation for senior managers would be considered and the Mid Staffordshire trust might lose its foundation status.

Some NHS chief executives have received six-figure redundancy packages or moved to other trusts despite poor performance. Martin Yeates, the former chief executive at Mid Staffordshire, received pay rises that took his annual salary to £180,000, while standards at the trust deteriorated. The Liberal Democrats claimed that he had also received a payoff of more than £400,000 after stepping down last March, though Mr Burnham said he had received “no more than his contractual entitlement”.

The Care Quality Commission, the NHS regulator, said that the trust under its new management was now “safe to provide services”. But it still had concerns about staffing, patient welfare, the availability and suitability of equipment at the trust, and how it monitored and dealt with complaints. The inquiry made 18 recommendations for the trust and the wider health service, which the Government accepted in full. They include a new review of how regulators and regional health authorities monitor NHS hospitals and a report on “early-warning systems” to identify failing trusts.

But the families of those who died or suffered poor care branded the inquiry a “whitewash” and repeated calls for a full public investigation. The Conservatives accused ministers of trying to blame managers rather than taking responsibility for problems with national targets. Julie Bailey, who founded the victims’ campaign group Cure the NHS after her mother died at Stafford Hospital, said that the handling of the scandal was disgraceful and unacceptable. “It is time that the public were told the truth about the very large number of excess deaths in NHS care and the very large number of avoidable but deadly errors that occur every day.”

The NHS Confederation, which represents health trusts, said: “The responsibility for the way this hospital was run rests with its board, management and staff but, as the report says, the framework of targets, regulatory systems and policy priorities it worked within are also very important.”

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Background

Postings from Brisbane, Australia by John Ray (M.A.; Ph.D.) -- former member of the Australia-Soviet Friendship Society, former anarcho-capitalist and former member of the British Conservative party.

This blog gives a lot of attention to events in Australia and Britain -- places where there already exist systems similar to the one most likely to befall the USA if the Democrats get their way -- "Free" medical care supposedly available to all through government hospitals but with a competing private sector as well. The Canadian system is considered too Soviet to provide a likely model for the USA

TERMINOLOGY: Many of my posts concern the very instructive state of socialized medicine in Australia. Like the USA, Germany and India, Australia has a system of State governments which have substantial independence from the central (Federal) government and it is they who are mainly responsible for "free" health services. It may therefore be useful to some for me to note the standard abbreviations for the States concerned: QLD (Queensland), NSW (New South Wales), WA (Western Australia), VIC (Victoria), TAS (Tasmania), SA (South Australia).

For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

Conservatives do NOT object to helping the poor. Government welfare legislation in aid of the poor was in fact first introduced by conservatives -- Bismarck and Disraeli in the 19th century. What conservatives want is for the help to be delivered in a sane manner. And anyone who thinks that government bureaucracies can run hospitals well is completely out of touch with reality.

One of the oldest "free" public hospital systems in the world is that in the Australian State where I live: Queensland. It dates from 1944 (Britain's NHS began in 1948). So its advanced state of decay reveals well where the slow cancer of bureaucracy ends up. It now has three "administrative" employees for every medical employee. All those clerks are really good at curing people, I guess! Frequent bulletins on the flailing but ineffectual attempts to "fix" the system will appear here -- as well as bulletins on the dreadful things it does to patients and the long waits they endure.

On all my blogs, I express my view of what is important primarily by the readings that I select for posting. I do however on occasions add personal comments in italicized form at the beginning of an article.

I am rather pleased to report that I am a lifelong conservative. Out of intellectual curiosity, I did in my youth join organizations from right across the political spectrum so I am certainly not closed-minded and am very familiar with the full spectrum of political thinking. Nonetheless, I did not have to undergo the lurch from Left to Right that so many people undergo. At age 13 I used my pocket-money to subscribe to the "Reader's Digest" -- the main conservative organ available in small town Australia of the 1950s. I have learnt much since but am pleased and amused to note that history has since confirmed most of what I thought at that early age.

I imagine that the the RD is still sending mailouts to my 1950s address!

NOTE: The archives provided by blogspot below are rather inconvenient. They break each month up into small bits. If you want to scan whole months at a time, the backup archives will suit better. See here or here